COM­MEN­TARY The Oba­macare omen

The fal­lacy of so­cial­ized medicine stands as a warn­ing to pos­ter­ity

The Washington Times Daily - - Metro - By Grady Means

Pres­i­dents with no ex­pe­ri­ence in the pri­vate sec­tor, and vir­tu­ally none in do­mes­tic or for­eign pol­icy, will al­ways be trapped by the law of un­in­tended con­se­quences. They just don’t un­der­stand how things work, or don’t work. While ig­no­rance might al­low them to speak with as­tound­ing con­fi­dence, they are of­ten shocked by the re­sults of their poli­cies. This par­tic­u­larly in­ex­pe­ri­enced pres­i­dent will go down, po­litely, as “his­tor­i­cally sur­prised.”

The cen­tral point made by con­ser­va­tive Repub­li­cans, or Democrats who ap­pre­ci­ate the free mar­ket, is that the pri­vate sec­tor, prop­erly di­rected, is the most ef­fec­tive way to cre­ate eco­nomic growth and solve com­plex prob­lems such as heath care cost con­trol, qual­ity and avail­abil­ity. Repub­li­can lead­er­ship has been en­tirely inar­tic­u­late on this point, though, or has got­ten lost in in­ternecine weeds and war­fare, and has not con­vinced the pub­lic of this fun­da­men­tal dif­fer­ence be­tween the Repub­li­can and Demo­cratic ap­proaches to gov­er­nance.

Now Pres­i­dent Obama has taken care of that with a gift that will re­set the course for Amer­i­can po­lit­i­cal de­bate for decades. Oba­macare, in par­tic­u­lar, and the Obama ad­min­is­tra­tion in gen­eral, have pro­vided the crys­tal-clear con­clu­sion that gov­ern­ment should not be put in charge of cre­at­ing huge, new or­ga­ni­za­tions for man­ag­ing mas­sive pro­grams of eco­nomic change, be­cause gov­ern­ment is, fun­da­men­tally, not as good as the pri­vate sec­tor at de­sign­ing and man­ag­ing th­ese types of in­sti­tu­tions.

In that con­text, if any­one ever needed a lab­o­ra­tory test or case study on why Amer­ica should never en­ter­tain the con­cept of a “sin­gle-payer,” gov­ern­men­trun health sys­tem, Oba­macare has pro­vided that. Even at this early stage, it is ob­vi­ous to nearly ev­ery­one that costs are sky­rock­et­ing, that there is a sin­is­ter wealth trans­fer from the young to the old and il­le­gal im­mi­grants, that doc­tors and health in­sur­ers are flee­ing, that avail­abil­ity and qual­ity of care will de­cline, that the gov­ern­ment is in­com­pe­tent to run this com­plex pro­gram, and that lies and po­lit­i­cal de­cep­tion have been used to cover all this up. It is un­likely that any sane politi­cian would ever again en­ter­tain the con­cept of “sin­gle-payer” so­cial­ized medicine.

Now some will ar­gue that Medi­care and Med­i­caid have been suc­cess­fully run by the gov­ern­ment for years. Re­ally? A care­ful look at the num­bers con­firms that the gov­ern­ment has been a com­plete fail­ure at con­trol­ling the costs of th­ese pro­grams, that they have driven up ev­ery­one else’s health care costs, that ham-fisted ap­proaches to squeez­ing doc­tors have re­placed com­pet­i­tive mar­ket mech­a­nisms that might have re­duced costs and im­proved qual­ity, that ben­e­fits and ac­cess to care have been subtly re­duced, that fraud may be as high as 30 per­cent of the pro­gram costs, and that Medi­care is on the brink of bank­ruptcy. Pri­vate-sec­tor busi­nesses, bred in a tough, com­pet­i­tive mar­ket, could do a mas­sively bet­ter job than that.

Of course, the real prob­lem with this ad­min­is­tra­tion is far more fun­da­men­tal than Oba­macare. The pres­i­dent has never built or man­aged a busi­ness of any sort. He has never stayed awake at night wor­ry­ing about meet­ing a pay­roll, get­ting a loan for his busi­ness, cre­at­ing a bud­get, con­trol­ling his costs, hold­ing em­ploy­ees ac­count­able, pay­ing his busi­ness taxes — ever. It is no won­der that he ap­pears to have no idea how to launch a pro­gram to re­struc­ture nearly one-fifth of the U.S. econ­omy. He and his se­nior team are, sim­ply, in­com­pe­tent (stat­ing it in the most po­lite way pos­si­ble). He doesn’t have any idea how to de­sign a health care pro­gram, how to cre­ate man­age­ment pro­cesses, how to run it, how to build in­for­ma­tiontech­nol­ogy sys­tems, how to pick peo­ple who do, how to price it, or how to hold any­one ac­count­able for any­thing. He re­ally had vir­tu­ally noth­ing to do with de­sign­ing the Oba­macare leg­is­la­tion, so he prob­a­bly didn’t know that a gov­ern­ment-run sys­tem like this wouldn’t work.

If he had ever par­tic­i­pated in the real U.S. econ­omy, even a lit­tle bit, he would have had a lot more re­spect for those who are com­pe­tent to build and run suc­cess­ful eco­nomic en­ter­prises. Com­pa­nies that com­pete and suc­ceed re­ally are mag­i­cal geese that lay golden eggs, and the United States, prop­erly led by those who un­der­stand that, has been amaz­ingly suc­cess­ful at breed­ing those magic geese, which feed us all.

If the pres­i­dent knew any­thing about the U.S. econ­omy, he would have un­der­stood that you do not starve your geese with mas­sive new taxes, you do not throw away all the golden eggs on worth­less gov­ern­ment pro­grams, and you do not be­have like a king when you are ex­pected to be an ac­count­able CEO.

The good news in this re­ally sad sit­u­a­tion is that the Amer­i­can peo­ple may be wak­ing up to the cred­i­bil­ity and com­pe­tence is­sues of this ad­min­is­tra­tion.

Oba­macare will fail. Medi­care will go bank­rupt.

At the same time, how­ever, ar­gu­ments and plans for a truly com­pet­i­tive, mar­ket-based, so­lu­tion to health care will fi­nally be heard. With that, the qual­ity and avail­abil­ity of health care can in­crease. Those with­out proper ac­cess to health care can get it. If the po­lit­i­cal process prop­erly frames the is­sue and al­lows the mar­ket to work, it will hap­pen. That is what Amer­ica does. The pres­i­dent should learn it, ap­pre­ci­ate it, sup­port it and not get in the way. He should lead from be­hind and sal­vage the rest of this ad­min­is­tra­tion.

ILLUSTRATION BY LINAS GARSYS

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